Individual
MARC LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
18031 ADRIFT RD, WINTER GARDEN, FL 34787-8471
(407) 205-8822
(866) 404-4006
Mailing address
18031 ADRIFT RD, WINTER GARDEN, FL 34787-8471
(407) 205-8822
(866) 404-4006
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9485045
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11023551
FL
Other
Enumeration date
12/09/2022
Last updated
07/13/2023
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